Gilead’s Antiviral Drug Remdesivir Benefits Some Hospitalized COVID-19 Patients in Clinical Trial

Preliminary findings of a clinical trial of Gilead Sciences’ (Foster City, CA, USA) remdesivir in adults hospitalized with COVID-19 support the use of the antiviral drug, although it is unlikely to be sufficient if taken alone.

Although several therapeutic agents have been evaluated for the treatment of COVID-19, none have yet been shown to be efficacious. Remdesivir (GS-5734), an inhibitor of the viral RNA-dependent, RNA polymerase with inhibitory activity against SARS-CoV and the Middle East respiratory syndrome (MERS-CoV), was identified early as a promising therapeutic candidate for COVID-19 because of its ability to inhibit SARS-CoV-2 in vitro.

For their study, the researchers conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in adults hospitalized with COVID-19 with evidence of lower respiratory tract involvement. Patients were randomly assigned to receive either remdesivir (200 mg loading dose on day 1, followed by 100 mg daily for up to 9 additional days) or placebo for up to 10 days. The primary outcome was the time to recovery, defined by either discharge from the hospital or hospitalization for infection-control purposes only.

The researchers found that remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with COVID-19 and evidence of lower respiratory tract infection. The preliminary results of the trial suggest that a 10-day course of remdesivir was superior to placebo in the treatment of hospitalized patients with COVID-19. This benefit was seen in the number of days to recovery. These preliminary findings support the use of remdesivir for patients who are hospitalized with COVID-19 and require supplemental oxygen therapy. However, given the high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient. Future strategies should evaluate antiviral agents in combination with other therapeutic approaches or combinations of antiviral agents to continue to improve patient outcomes in COVID-19.

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